A Multicenter Study of Antimicrobial Susceptibility of Uropathogens Causing Acute Uncomplicated Cystitis in Woman

PURPOSE: Worldwide data shows that there is an increasing resistance among urinary tract pathogens to the first-line antimicrobial agents used in domestic areas. The objective of this study was to obtain data on the susceptibility patterns of the pathogens responsible for acute uncomplicated cystitis to currently used antimicrobial agents. MATERIALS AND METHODS: This study was carried out with the participation of fifteen hospitals in South Korea. A total of 239 isolates were obtained from female outpatients with acute uncomplicated cystitis. The antimicrobial susceptibilities to ampicillin, ampicillin/sulbactam, ciprofloxacin, gentamicin, trimethoprim/sulfamethoxazole (TMP/SMX) and tobramycin were determined by Vitek antimicrobial susceptibility test systems. RESULTS: The most prevalent causative organism was Escherichia coli (79.9%), followed by coagulase negative Staphylococcus (4.2%), and a combination of other species of Enterobacteriaceae (8.2%). The mean rates of susceptibility were 35.5, 45.0, 85.7, 81.5, 62.1 and 85.3% to ampicillin, ampicillin/sulbactam, ciprofloxacin, gentamicin, TMP/ SMX and tobramycin, respectively. No significant differences were detected in the resistance rates between the results from 4 regional groups. CONCLUSIONS: The high prevalence of resistance to ampicillin, ampicillin/sulbactam, and TMP/SMX suggest these drugs would not provide adequate initial therapy, and therapies other than TMP/SMX may need to be considered. The relatively high prevalence of resistance to ciprofloxacin, compared with other countries, also requires on going surveillance to identify further changes among urinary tract isolates.ope